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MARIELLE TAVARES
NPI 1376282475
Nurse Practitioner - Family in Los Angeles, CA

Active since May 27, 2022PECOS EnrolledAccepts Medicare Assignment
808 W 58TH ST, LOS ANGELES, CA 90037(310) 948-6356 Get Directions Write a Review

NPPES record last updated: May 27, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Marielle Tavares NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARIELLE TAVARES (NPI 1376282475) is an individual family provider in Los Angeles, California, licensed in California (95020541) and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS and is a graduate of University Of Southern California Keck School Of Medicine (2021).

NPPES Registry Identity

NPI1376282475
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMARIELLE TAVARES
Location Address808 W 58TH STLos Angeles, CA 90037-3632
Mailing Address5743 Ventura Canyon AveValley Glen, CA 91401-4533 · (310) 948-6356
Phone(310) 948-6356
Sole ProprietorYes
Medical School CMSUniversity Of Southern California Keck School Of MedicineGraduated 2021
Enumeration DateMay 27, 2022
NPPES CertifiedMay 27, 2022
✔ NPI 1376282475 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 95020541
808 W 58TH ST, Los Angeles, CA 90037
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Marielle Tavares is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9032585682
PECOS Enrollment IDI20221021002445
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90037 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TAMMY SUE TOWNS APRN
Nurse Practitioner (Women's Health)
808 W 58TH ST
LOS ANGELES, CA 90037
Los Angeles County (323) 541-1400
DAVID K YOO NP
Nurse Practitioner (Family)
808 W 58TH ST
LOS ANGELES, CA 90037
Los Angeles County (323) 541-1411
GABRIELLA OLOYE RN, FNP
Nurse Practitioner (Family)
808 W 58TH ST
LOS ANGELES, CA 90037
Los Angeles County (323) 541-1141
KIMI YAMAMOTO
Dentist (Orofacial Pain)
808 W 58TH ST
LOS ANGELES, CA 90037
Los Angeles County (323) 285-9830
DR. SAGHAR SABER M.D
Internal Medicine (Infectious Disease)
808 W 58TH ST
LOS ANGELES, CA 90037
Los Angeles County (323) 541-1411
INGEBORG WESTIEN MD
Pediatrics
808 W 58TH ST
LOS ANGELES, CA 90037
Los Angeles County (323) 541-1600
KEISHA NERISE CONWRIGHT FNP
Nurse Practitioner (Family)
808 W 58TH ST
LOS ANGELES, CA 90037
Los Angeles County (323) 541-1600
DR. DEANDRA NICHELLE TURNER D.D.S.
Dentist (Pediatric Dentistry)
808 W 58TH ST
LOS ANGELES, CA 90037
Los Angeles County (323) 541-1600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marielle Tavares's NPI number?

The NPI number for Marielle Tavares is 1376282475. It was assigned to this individual provider in the NPPES registry on May 27, 2022.

Where is Marielle Tavares located?

Marielle Tavares practices at 808 W 58th St, Los Angeles, CA 90037. The listed phone number is (310) 948-6356.

What is Marielle Tavares's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Marielle Tavares enrolled in Medicare?

Yes. Marielle Tavares is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Marielle Tavares was last updated on May 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.